Deconstructing what's actually being said is helpful for consumers who are health industrial complex voters.
On 10/23/2018, I considered the headlines touting the two percent drop in silver benchmark plans for plan year 2019, (The Benchmark Silver Plan Deconstructed, Obamacare: Not Still Stupid).
What the cheaper Obamacare headlines turn out to be talking about is that IF you are one of the around 11 million consumers who purchase health insurance on an Obamacare exchange, IF your state is one of the states that's charging less for the benchmark silver plans, the second lowest cost for your state, IF you're in one of the 39 states that participates on the federally run exchanges, THEN, depending on your state you might be paying less and you might be paying more and you might see no change, since the average is for all states not necessarily your state. Kind of changes the headline.
Then there's THE HARWOOD FILE from 10/23/2018 on CNBC.com, "Obamacare could expand after the midterm elections, despite GOP efforts to undermine it." Let's deconstruct that one, it's a great way to inform our health care voter decisions.
Immediately we find out that the article is dealing with EXPANDED MEDICAID, the near free or free health insurance to obtain (eg no premiums) and the near free or free health insurance to use, for people who are often NOT required (not mandated) to have health insurance at all because their income is too low. There are many other exemptions to the individual mandate, many removing the potential tax penalty for NOT purchasing the consumer financial product of health insurance if your income is too low or non-existent.
So the headline refers to EXPANDED MEDICAID, not the Obamacare program that applies to consumers using exchanges.
This is important regarding the relentless claim by Democrats that Obamacare was "working" by reducing the number of uninsured for TWO reasons: First, near free health insurance and near-free medical services for those below certain income levels or those with no income, eg Medicaid, was already in existence and EXPANDING eligibility reflected the exorbitant and unaffordable prices of health insurance and health services in our country and second because this near-free health insurance and health services was wrongfully used to bolster ideas that Obamacare EXCHANGES were "working" since more than HALF of the reduction in the uninsured is credited to Medicaid expansion.
The number of people who became insured using exchanges, even using the most optimistic enrollment number of 11 million for a year (optimistic because those numbers change as people drop out, and the number never counted how many people had other insurance that they could no longer obtain after Obamacare and therefore were forced onto exchanges and more significantly were NOT newly insured), is LOWER than the number of people using Medicaid. In all its machinations, Obamacare was less successful than the simple relaxation of eligibility requirements for people to obtain Medicaid for health insurance.
As PolitiFact determined on January 15, 2017, Jon Greenberg writes, "Medicaid might account for slightly more than half of those who gained coverage. Most people wouldn’t say that amounts to the vast majority, but it is likely still the majority."
Consumers know this, pre and post Obamacare health insurance is too expensive and with the other outlays of cash that went up under Obamacare including higher deductibles, higher copays and higher coinsurance, coverage remains too expensive, so talking about more people who can get near free insurance coverage and services under Medicaid is not a sign that Obamacare is working.
Further highlighting that Obamacare was and is NOT what President Obama promised it would be and do for Americans EVEN regarding expanded Medicaid, the Obama Administration and Obamacare architect Jonathan Gruber, the guy who revealed that Obamacare relied on the stupidity of the American voter to pass, also revealed that millions of new Medicaid recipients, "…were eligible before the Affordable Care Act took effect," PolitiFact, Jon Greenberg, 1/15/2017.
Secondly, but equally important is what Medicaid expansion confirms about Obamacare, the complicated scheme to force people to purchase the health insurance product and the idea that if you're forcing them then the federal government should help pay for it, the premium assistance and cost-sharing of Obamacare exchange plans.
This was also the theory behind the generous expanded Medicaid provisions the Obama Administration put forth, using the same carrot and stick mentality, the carrot being the generous government payments to states to cover the new Medicaid recipients under expanded Medicaid and the stick that if they didn't participate then states would lose all the federal contribution to Medicaid in their states.
Unfortunately the Supreme Court strained reason and concluded one way regarding forcing states to participate in Obamacare and another in forcing individuals to purchase the consumer financial product of health insurance.
In 2012, in National Federation of Independent Business (NFIB) v. Sebelius, the Supreme Court would NOT permit Obama through Obamacare to force states to expand Medicaid or lose ALL their Medicaid funding from the federal government in a nod to states' rights. However, the same decision UPHELD the individual mandate as a legitimate tax penalty on individuals forcing consumers to purchase health insurance.
Expanded Medicaid became a CHOICE for states and a well-funded one where the federal government would carry almost all the expenses of insuring newly eligible individuals under Medicaid. When you consider this, it's not at all surprising that more states are considering jumping on the mostly fed-paid expanded Medicaid bandwagon.
Back to the headline, "Obamacare could expand," now we know it's only referring to the mostly fed-paid expanded Medicaid program where there are states considering expansion." OK, "Obamacare could expand after the midterm elections…" That's referring to certain states with "Medicaid-related ballot initiatives," so naturally if those initiatives get voted in, then Medicaid expansion would be voted in.
OK, "Obamacare could expand after the midterm elections, despite GOP efforts to undermine it." This is an UNRELATED campaign spinning. Democrats promising not to cut Medicaid, Social Security and Medicare and Republicans complaining we can't afford it. Neither side is truthful on this and based on President Obama's brazen campaign falsehoods about Obamacare, even earning him lie of the year status in 2013, and I'm not willing to be "stupid" about those promises from self-interested candidates who are already enjoying their superior benefits off our backs to the tune of up to 75 percent of their health insurance costs, let alone their other public employee federal benefits programs.
